Expanding parallel jaw device for use with an electromechanical driver device

ABSTRACT

A cutting and stapling device for use as an attachment to an electromechanical device driver comprises an upper jaw and a lower jaw which separate and close against one another in a continuously parallel alignment. The upper jaw includes a series of staple guides corresponding to one or more staples in a removable staple tray disposed within a lower jaw, whereby a blade and wedge having a threaded bore travel upon a matching threaded shaft in a channel disposed in the lower jaw below the staple tray, such that rotation of the threaded shaft causes movement of the wedge through the channel while a sloped surface of the wedge contacts the staples to push the staples against the staples guides, closing the staples.

BACKGROUND OF THE INVENTION

[0001] 1. Field of the Invention

[0002] The present invention relates generally to an attachment for anelectromechanical device for use with anastomosing, stapling, andresecting surgical tools, and more specifically to a stapling andresecting device which can be attached to and serve as an extension ofan electromechanical device driver, and most specifically to theexpanding parallel jaws and the mechanisms thereof.

[0003] 2. Description of the Prior Art

[0004] Upon identification of cancerous and other anomalous tissue inthe gastrointestinal tract, surgical intervention is often prescribed.The field of cancer surgery, and more specifically, the surgicalprocedure by which a section of the gastrointestinal tract whichincludes cancerous tissue is resected, includes a number of uniquelydesigned instruments. In combination with a description of the presentinstrumentation and their functions, a description of the state of theart in this surgical procedure shall also be provided.

[0005] The first question which must be answered when determining how totreat gastrointestinal tract cancer relates to the specific location ofthe cancerous tissue. This is very important insofar as the instrumentswhich are provided in the present art have limitations relating to howfar they may be inserted into the gastrointestinal tract. If thecancerous tissue is too far up or down the gastrointestinal tract, thenthe standard instrumentation provided is unusable, thus requiringspecial accommodations. These accommodations generally increase the riskof contamination of the surrounding tissues with bowel contents,increase the length of the surgery and the corresponding need foranesthesia, and eliminate the benefits of precise anastomosing andstapling which comes from utilizing a mechanized device.

[0006] More specifically, in the event that the cancerous tissue islocated at a position in the colon which is accessible by the presentinstrumentation, the patient's abdomen is initially opened to expose thebowel. The surgeon then cuts the tube of the colon on either side of thecancerous tissue, while simultaneously stapling closed the two open endsof the bowel (a distal end which is directed toward the anus, and theproximal end which is closest to the lower intestine). This temporaryclosure is performed in order to minimize contamination. The linearcutter and stapling instrument which is used in the prior art isprovided in a perspective view in FIG. 1.

[0007] More particularly, this temporary closure is achieved when thecolon is placed between the scissoring elements at the tip of the linearcutter and stapling instrument. By squeezing the trigger in the handleof the device, the surgeon causes the scissoring elements to cometogether. A second trigger (or a secondary action of the same trigger)is then actuated to drive a series of staples and a cutting bladethrough the clamped end of the colon, thereby closing and transectingthe ends.

[0008] After the sealing of the two exposed distal and proximal ends,the surgeon creates a small opening in the proximal end of the bowel andinserts the removable anvil portion of an anastomosing and staplinginstrument. This step, as well as those of the remainder of the surgicalprocedure, are related to the functioning of this surgical instrumentwhich is provided in a perspective view in FIG. 2. More particularly,the surgeon begins by taking the instrument and manually turning thedial at the base of the handle which causes the anvil head at theopposite end to advance forward. The surgeon continues to turn the dialuntil the anvil head advances to its most extreme extended position.This manual turning requires nearly thirty full rotations. Once fullyextended, the anvil head of the instrument is decoupled therefrom and isinserted into the exposed proximal end such that the coupling postextends outwardly therethrough. As described above, this proximal end isthen stapled closed. The extending shaft of the anastomosing, andstapling instrument is then inserted and advanced into the lower colon,transanally, until the coupling stem thereof extends through the stapleddistal end. The surgeon then joins the coupling ends of the anvil andshaft together and begins to manually rotate the dial in the handleagain, this time bringing the anvil head closer to the tip of the shaft.

[0009] Once the anvil head and shaft are brought close together, afterthe surgeon has manually rotated the dial another thirty times, agrip-style trigger in the handle is manually actuated. This actuationcauses a circular blade to advance axially out from the tip of theshaft, and into contact with the opposing face of the anvil. The bladecuts through the stapled-closed ends of the proximal and distal ends ofthe colon, thereby also cutting a new pair of ends of the proximal anddistal portions of the colon. The tissue which has been severed is heldin an interior volume at the end of the shaft.

[0010] In lock step with the cutting, the freshly opened ends are joinedtogether by a series of staples which are advanced through holes in theperimeter of the tip of the shaft (being pressed against and closed bythe opposing face of the anvil). The coupled shaft and anvil are thenwithdrawn from the patient.

[0011] More particularly with respect to the structural features of thelinear stapling instrument of the prior art which is provided in FIG. 1,the device comprises a pistol grip-styled structure having an elongateshaft and distal portion. The distal portion includes a pair ofscissors-styled gripping elements which clamp the open ends of the colonclosed. In fact only one of the two scissors-styled gripping elements,the anvil portion, moves (pivots) relative to overall structure; theother remains fixed. The actuation of this scissoring means (thepivoting of the anvil portion) is controlled by means of a grip triggermaintained in the handle. A number of different means have beendisclosed for holding the tips of the scissoring arms closed, includingsnaps, clips, collars, et al.

[0012] In addition to the scissoring means, the distal portion alsoincludes a stapling mechanism. The non-moving element of the scissoringmechanism includes a staple cartridge receiving region and a mechanismfor driving the staples up through the clamped end of the colon, againstthe anvil portion, thereby sealing the previously opened end. Thescissoring elements may be integrally formed with the shaft, or may bedetachable such that various scissoring and stapling elements may beinterchangeable.

[0013] More particularly with respect to the structural features of theanastomosing and stapling instrument of the prior art which is providedin FIG. 2, the device comprises an anvil portion, a staple, blade andreservoir portion, a shaft portion, and a handle portion. The anvilportion, which is selectively removable from the tip of the shaft, isbullet shaped, having a blunt nosed top portion, a flat cutting supportsurface on the bottom, and a coupling post extending axially from thebottom surface.

[0014] The staple, blade, and reservoir portion (SBR portion) of theinstrument is provided at the distal end of the instrument, and includesa selectively advanceable and retractable coupling stem for selectivelyreceiving thereon the anvil portion. This action of the coupling stem isprovided by a screw threaded shaft and worming mechanism mounted in thehandle (described more fully below). The SBR portion is cylindrical inshape, forming a housing which has a hollow interior. It is this hollowinterior which forms the reservoir. The blade is similarly cylindrical,and seats in the inside of the housing, against the inner wall thereof.The blade is selectively advanceable axially outward from the housing,in accordance with actuation of a trigger mechanism of the handle(again, described more fully below). On the axially outward facingsurface of the cylindrical wall of the housing are a series of stapleports, through which the staples of the device are discharged. The sameactuation which drives the blade forward similarly drives a series ofstaple drivers forward within the cylindrical walls. More accurately,the staple driver is a cylindrical component which has a series ofprotuberances on the axial end thereof, the protuberances beingpositioned in accordance with the distribution of staples and holes. Thestaples, prior to being discharged, are mounted in the holes; and theyare advanced through the holes by the action of the staple driver andthe protuberances thereof.

[0015] The shaft portion of the instrument is a simple rigid extendedstructure which is intended as a sheath for a pair of elongate rods. Thefirst rod is coupled to the worming mechanism introduced above, anddescribed more fully below with respect to the handle portion, and isthe means by which the anvil portion and the coupling stem of the SBRportion are selectively advanced and retracted. The second rod iscoupled to the trigger of the handle at one end (also introduced above,and described more fully below) and to the blade and staple driver atthe other end. The sheath protects the patient and the, instrument whenit is advanced into the colon transanally. The nature of the actuationmechanisms however, requires that the shaft be rigid. This rigiditylimits the length of the shaft; and combination, i.e. the length andrigidity of the instrument, these features limit the sections of thecolon which may be treated using this device.

[0016] The handle of this instrument of the prior art comprises a pistolgrip styled structure having a turning dial at the butt (i.e. the endopposing the junction of the shaft portion which the handle) and afinger actuated trigger. The trigger includes a safety mechanism whichphysically prevents actuation unless moved out of the interferenceposition. The turning dial is actionably coupled to a worming mechanismwhich is used to advance the first rod of the shaft portion (therebyadvancing the coupling stem and the anvil). The trigger functions as abasic lever to push the second rod forward within the shaft, therebyadvancing the blade and staple driver.

[0017] As with many such devices of the prior art, all of these devicesare considered fully disposable, and are, in fact, thrown away after asingle use. They are complicated devices, having multiple moving parts,requiring substantial structural integrity and, therefore, expense inmanufacturing. The fact that they are used only once, and no part can beused again render the use of such devices expensive and wasteful ofresources.

[0018] In addition to this failure, as can be readily observed from thepreceding descriptions, the prior art devices suffer from numerous otherlimitations which would be desirable to overcome. These include therigid and limited length shaft of the devices, as well as therequirement that the surgeon manually actuate all of the features andfunctions.

[0019] Therefore, it is a principal object of the present invention toprovide an instrument for resecting and stapling gastrointestinal tissueduring colon surgery, which reduces the waste of resources by permittinguse as an attachment to an electromechanical device driver.

[0020] It is further an object of the present invention to provide aninstrument assembly which reduces the requirements for the surgeon tomanually actuate different components and mechanisms.

[0021] It is further an object of the present invention to provide aresecting and stapling mechanism that can be integrated with otherelectromechanical devices into an attachment for use with anelectromechanical device driver.

[0022] Other objects of the present invention shall be recognized inaccordance with the description thereof provided hereinbelow, and in theDetailed Description of the Preferred Embodiment in conjunction with theremaining Figures.

SUMMARY OF THE INVENTION

[0023] The preceding objects of the invention are provided by virtue ofan electromechanical resecting and stapling attachment which iscoupleable to and remotely actuateable by an electromechanical devicedriver. In particular, the attachment includes a pair of linearlyspreading jaws for clamping the selected section of gastrointestinaltissue therebetween, said jaws expanding and closing in a paralleldisposition. More particularly, the linear clamping mechanism of theattachment is used to first clamp the section of colon, and then to holdthe colon in place as a blade extends along a track in the lower jaw ofthe clamping attachment to cut the section of bowel, and then drives aseries of staples through the two opened ends so that the contents ofthe bowel are not permitted to empty into the surrounding region of theabdomen. This attachment, and others necessary to perform the remainderof the surgery, is coupled to an electromechanical driver which isdescribed more fully hereinbelow.

[0024] More particularly, with respect to the electromechanical driver,the driver has a handle and a flexible drive shaft. The handle has apistol grip-styled design, having a pair of finger triggers which areindependently coupled to separate motors which each turn separateflexible drive shafts (described more fully, hereinbelow). The motorsare each dual direction motors, and are coupled to a manual drive switchmounted to the top of the handle, by which the user can selectivelyalter the turning direction of each motor. This dual direction capacitymay be most simply achieved by selecting motors which turn in adirection corresponding to the direction of current, and actuation ofthe drive switches alters the direction of the current accordingly. Inthis example, the power source supplying the motors must be a directcurrent source, such as a battery pack (and most desirably, arechargeable battery pack). In the event that the device should beuseable with an alternating current, either a transformer can beincluded, or a more sophisticated intermediate gearing assembly may beprovided. In conjunction with the present description, the embodimentsof the present invention which will be described utilize a rechargeablebattery pack providing a direct current.

[0025] In addition to the motor components, the handle further includesseveral other features, including: (1) an remote status indicator; (2) ashaft steering means; and (3) at least one additional electrical supply.First, the remote status indicator may comprise an LCD (or similar readout device) by which the user may gain knowledge of the position ofcomponents (for example whether a clamping element is in the properposition prior to the driving of the staples). Second, the handle alsoincludes a manually actuateable steering means, for example, a joystickor track ball, for directing the movement of the flexible shaft (bymeans of guidewires implanted in the shaft portion described more fullyhereinbelow). Finally, the handle may include an additional electricalpower supply and an on off switch for selectively supplying electricalpower to the attachments.

[0026] More particularly, with respect to the flexible shaft, the shaftcomprises a tubular sheath, preferably formed of a simple elastomericmaterial which is tissue compatible and which is sterilizable (i.e. issufficiently rugged to withstand an autoclave). Various lengths of thisshaft may be provided in conjunction with the present invention. In thiscase, the flexible shaft and the handle portions should be separable. Ifseparable, the interface between the proximal end of the shaft and thedistal end of the handle should include a coupling means for the drivecomponents. Specifically regarding the drive components of the shaft,within the elastomeric sheath are a pair of smaller fixed tubes whicheach contain a flexible drive shaft which is capable of rotating withinthe tube. The flexible drive shaft, itself, simply must be capable oftranslating a torque from the motor in the handle to the distal end ofthe shaft, while still being flexible enough to be bent, angled, curved,etc. as the surgeon deems necessary to “snake” through the bowel of thepatient. For example, the drive shafts may comprise a woven steel fibercable. It shall be recognized that other drive shafts may be suitablefor this purpose. In order for the distal end of the drive shaft tocouple with an attachment, such as the clamping and stapling device ofthe present invention (as described more fully below), however, thedistal tips of the drive shafts must have a conformation which permitsthe continued translation of torque. For example, the distal tips of thedrive shafts may be hexagonal, thereby fitting into a hexagonal recessin the coupling interface of the attachment. As suggested above, inconjunction with the manually actuateable steering means mounted to thehandle, the sheath further includes at least two guidewires which areflexible, but are coupled to the inner surface of the sheath near thedistal end thereof. The guidewires may be axially translated relative toone another by actuation of the steering means, which action causes thesheath to bend and curve accordingly. Also, as suggested above, inconjunction with the LCD indicator of the handle, the shaft furthercontains an electrical lead for coupling to the attachments. Thiselectrical lead channels a signal from the attachment to the handle forindicating the status of the attachment (for example, whether a clampingfunction is holding). Similarly, a second electrical lead may beprovided to supply power to separate aspects of the attachment if sorequired (for example, as will be described more fully with respect tolinear resecting and stapling attachment, the use of selectivelyengageable electromagnetic seal for ensuring continued clamping throughthe stapling process may be provided and require power selectivelyprovided from the handle's power supply).

[0027] More particularly, with respect to the linear resecting,clamping, and stapling attachment which is the specific subject of thisinvention, the attachment is fitted with two drive extensions, which inoperation function as extensions of the flexible drive shafts of theelectromechanical driver. That is, when the attachment is mated to theelectromechanical driver, the drive extensions are in mechanicalcommunication with the flexible drive shafts such that the activation ofthe drive shaft motors activates the drive extensions within the linearclamping, cutting and stapling attachment. The first drive extensionenables the parallel spreading and closing of the jaws of the device,which form a linear clamping mechanism, while the second drive extensionenables a cutting and stapling mechanism. More particularly, the linearclamping mechanism comprises a separating jaw system whereby an upperjaw is raised to permit the bowel tissue to be placed therebetween, andsubsequently the jaws are closed to meet to effect a clamping. In afirst embodiment, the first drive extension engages a pair of threadedvertical shafts which raise or lower the upper jaw depending on theturning direction of the corresponding motor in the electromechanicaldriver. In a second embodiment, the first drive extension includes onlya single angled gearing mechanism mounted at the end of the horizontallyrotating shaft (which is coupled to one of the turning shafts of theelectromagnetic driver). This gearing mechanism causes the verticallyrotation of a threaded shaft on which the upper jaw is separatelymunted. In both embodiments, when the jaws are closed, a pair of sensorelectrodes disposed on the jaws come into contact and thereby complete asensor circuit which alerts the surgeon that it is safe or appropriateto activate the resecting and stapling mechanism and/or automaticallyactivates the resecting and stapling mechanism.

[0028] In each of these embodiments, the second driver causes a blade toslide along a track in the lower jaw, which blade cuts the bowel,briefly leaving two open ends. Nearly simultaneous with the cutting, astapling mechanism drives a series of staples upwardly through openingin the lower jaw, toward the upper jaw, through the open ends, therebyclosing the bowel segments. This stapling action happens nearlysimultaneous with the cutting in part because the blade is contiguouswith a stapling mechanism of the present invention.

[0029] This stapling mechanism begins with a replaceable tray of openstaples which is set within the lower jaw, the tray having two rows ofstaples separated along the long axis of the jaw so that the blade maytrack between the rows. The opposing upper jaw face includes a set ofcorresponding staple guides, such that when the linear clampingmechanism is in a closed position, the open staples immediately opposethe corresponding staple guides. This mechanism comprises a wedgepushing system whereby once the linear clamping mechanism is in a closedposition, the blade and a wedge ride along together in a channel belowthe tray of open staples, and the staples are pushed up toward thestaple guides, through the bowel. More particularly, as the wedge movesthrough the channel, a sloping surface of the wedge pushes the openstaples against the corresponding staple guides, thereby closing thestaples. After the staples have been closed, the wedge is pulled backthrough the channel. It is the first drive mechanism which lifts thejaws apart in parallel; and it is the second drive mechanism whichpushes or pulls the wedge and blade mechanism through the channel. Thedirection of the first and second mechanisms is related solely to theremote operation of the driver, and the corresponding turning directionof the shafts, of the electromechanical driver.

BRIEF DESCRIPTION OF THE DRAWINGS

[0030]FIG. 1 is a perspective view of a linear clamping, cutting andstapling mechanism of the prior art;

[0031]FIG. 2 is a perspctive view of an anastomosing and staplingmechanism of the prior art.

[0032]FIGS. 3 and 4 are side views of the closed and open dispositions,respectively, of a linear clamping, cutting and stapling attachmentwhich is an aspect of the present invention;

[0033]FIGS. 5 and 6 are cutaway side views of the closed and opendispositions, respectively, of the linear clamping, cutting and staplingattachment shown in FIGS. 3-4 which is an aspect of the presentinvention;

[0034] FIGS. 7-14 are rear views in various cutaway planes of the linearclamping, cutting and stapling attachment shown in FIGS. 3-6 which is anaspect of the present invention;

[0035] FIGS. 15-19 are bottom, top cutaway, deep top cutaway, bottomcutaway, and top views, respectively, of the linear clamping, cuttingand stapling attachment shown in FIGS. 3-14 which is an aspect of thepresent invention;

[0036]FIG. 20 is a side cutaway of the linear clamping, cutting andstapling attachment shown in FIGS. 3-19 which is an aspect of thepresent invention;

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0037] A preferred embodiment of the resecting and stapling attachmenthaving expanding jaws which remain parallel, according to the presentinvention, is illustrated in FIGS. 3-20. More particularly, referringnow to FIGS. 3, 4 and 15, a linear clamping mechanism and a stapling andcutting mechanism according to the present invention are shown as partof a linear clamping, cutting and stapling attachment 20. Referring nowalso to FIGS. 5 and 6, in this preferred embodiment, the linear clampingmechanism comprises a parallel separating jaw system comprising a lowerjaw 50 and an upper jaw 80 having a proximal end 100. Referring now alsoto FIGS. 9, 13, 16 and 19, the proximal end 100 of the upper jaw 80 hasa pair of threaded vertical bores 90, through which extend acorresponding pair of vertical shafts 130. Inner threads 92 of thevertical bores 90 match outer threads 132 of the vertical shafts 130.Referring now also to FIGS. 8 and 12, the vertical shafts 130 engage athreaded upper horizontal shaft 150 at a distal end 140 of the upperhorizontal shaft 150. Outer threads 152 of the upper horizontal shaft150 interlock with the outer threads 132 of the vertical shafts 130.Referring now to FIGS. 5-7 and 11, the upper horizontal shaft 150 has ata proximal end 170 an upper drive socket 180.

[0038] Referring to FIGS. 5-8, 11, 12, 16 and 19, the linear clampingand cutting mechanism further comprises a first sensor electrode 182electrically communicating via communication wires (not shown) with afirst contact pad 187 (best shown in FIGS. 8, 12, 16 and 19) which inturn electrically communicates with a second contact pad 189 (best shownin FIGS. 14 and 17) via direct contact, which electrically communicatesvia communication wires (not shown) with a first contact node 188 (bestshown in FIGS. 7, 11 and 15). Similarly, the linear clamping mechanismfurther comprises a second sensor electrode 184 electricallycommunicating via communication wires (not shown) with a second contactnode 186 (best shown in FIGS. 7, 11 and 15). The contact nodes 186, 188electrically communicate with communication wires (not shown) in theelectromechanical drive component (not shown) to form a sensor circuit,such that when the upper jaw 80 and the lower jaw 50 are clampedtogether, the sensor electrodes 182, 184 are in contact, the sensorcircuit is closed, and the surgeon is alerted via other circuitcomponents (not shown) to the clamped position of the jaws 50, 80, andis therefore informed that it is safe and/or appropriate to active thestapling mechanism.

[0039] Further in this preferred embodiment, and referring now to FIGS.5, 6, 10, 14, 18 and 20, the cutting and stapling mechanism comprises awedge pushing system comprising in the lower jaw 50 a replaceable tray220 housing one or more fastening rods, or staples 230, and in the upperjaw 80 one or more staple guides 240 corresponding to the staples 230.Each of the staples 230 has a butt 232 protruding below the tray, 220,and a pair of prongs 234 extending to the top of the tray 220. Referringnow also to FIGS. 9, 13 and 17, the wedge pushing system furthercomprises a wedge guide, or channel 250 extending beneath the tray 220.Within the channel 250 extends a threaded lower horizontal shaft 260having outer threads 262. Upon the lower horizontal shaft 260 travels awedge 270 having a sloped top face 280, a horizontal threaded bore 290(best shown in FIGS. 9 and 12) coaxial with the channel 250, having andinner threads 292 matching the outer threads 262 of the lower horizontalthreaded shaft 260, and an upwardly extending blade member 51. Referringnow to FIGS. 5, 6, 7 and 11, the lower horizontal shaft 260 has at aproximal end 300 a second drive socket 310.

[0040] In operation, after the surgeon has located the cancerous oranomalous tissue in the gastrointestinal tract, the patient's abdomen isinitially opened to expose the bowel. Utilizing the remote actuationprovided by the electromechanical driver assembly, the surgeon drives,the upper and lower jaws of the linear cutting and stapling attachmentinto the open position. The surgeon then places the tube of the bowel ona side adjacent to the cancerous tissue between the parallel spreadjaws. Again, by remote actuation, the surgeon causes the upper drivemechanism to engag in reverse, and the upper jaw closes, in a parallelalignment, onto the bowel and the lower jaw. Once the bowel has beensufficiently clamped, the surgeon engages the second drive mechanism,which causes the blade and wedge staple driver to advancesimultaneously, thereby cutting and stapling the bowel. The surgeon thenrepeats this step on the other side of the cancerous tissue, therebyremoving the section of bowel containing the cancerous tissue, which isstapled on either end to prevent spilling of bowel material into theopen abdomen.

[0041] More particularly, the linear clamping, cutting and staplingattachment is mated to the attachment socket (not shown) of theelectromechanical driver component (not shown) such that the upper drivesocket 180 engages the corresponding flexible drive shaft (not shown) ofthe electromechanical driver component (not shown) and the second drivesocket 310 engages the corresponding flexible drive shaft (not shown) ofthe electromechanical driver component (not shown). Thus, rotation ofthe upper horizontal shaft 150 is effected by rotation of the upperdrive socket 180 which is effected by rotation of the correspondingflexible drive shaft (not shown) of the electromechanical drivercomponent (not shown). Clockwise or counter-clockwise rotation isachieved depending on the direction of the responsible motor (notshown). Similarly, rotation of the lower horizontal shaft 260 iseffected by rotation of the second drive socket 310 which is effected byrotation of the corresponding flexible drive shaft (not shown) of theelectromechanical driver component (not shown). Again, clockwise orcounter-clockwise rotation is achieved depending on the direction of theresponsible motor (not shown).

[0042] In order to clamp the exposed ends of the bowel, the surgeonfirst activates the upper motor 400 corresponding to the upper flexibledrive shaft 410 which engages the upper drive socket 180 at the proximalend 170 of the upper horizontal shaft 150, thereby causing the upperhorizontal shaft 150 to turn in a clockwise rotation. When the linearclamping and stapling attachment is in an initial closed state as shownin FIG. 3, this clockwise rotation of the upper horizontal shaft 150causes the outer threads 152 of the upper horizontal shaft 150 to engagethe outer threads 132 of the vertical shafts 130, thereby causing thevertical shafts 130 to turn in a clockwise rotation. This clockwiserotation of the vertical shafts 130 causes the outer threads 132 of thevertical shafts 130 to channel within the inner threads 92 of thevertical bores 90, thereby causing the upper jaw 80 to rise in acontinuous fashion, in a parallel alignment with the fixed lower jaw,and begin separating from the lower jaw 50. Continuous operation of themotor in this manner eventually places the linear clamping and staplingattachment in an open state, providing a space between the upper jaw 80and the lower jaw 50, as shown in FIG. 4. Once the linear clamping andstapling attachment is in this open state, the surgeon has access to thetray 220 of staples 230, and can check to ensure that the staples 230are ready for the procedure and/or replace the tray 220 with a moresuitable tray 220. Once the surgeon has verified that the tray 220 isready and in place, the surgeon places the open distal end of the colonbetween the upper jaw 80 and lower jaw 50. Thereafter, the surgeonreverses the upper motor 400 to effect a counter-clockwise rotation ofthe upper horizontal shaft 150, which in turn effects counter-clockwiserotation of the vertical shafts 130, which in turn effects a lowering ofthe upper jaw 80, also in continuous parallel alignment. Continuousoperation of the upper motor 400 in this manner eventually returns thelinear clamping and stapling attachment to a closed state, where thedistal end of the bowel is clamped between the upper jaw 80 and thelower jaw 40, with a small portion of the distal end of the bowelextending laterally beyond the upper jaw 80 and the lower jaw 50.

[0043] Once the distal end of the bowel is clamped as described above,the sensor electrodes 182, 184 are in contact, and the surgeon isalerted via circuit components in the electromechanical drive componentthat it is safe and/or appropriate to activate the cutting and staplingmechanism. The surgeon then activates the cutting and staplingmechanism. It should be noted that the resistance afforded by themechanical relationships between the upper jaw 80, vertical bores 90,vertical shafts 130, horizontal shaft 150, and upper drive socket 180 ofthe linear clamping and stapling attachment, and the upper flexibledrive shaft and upper motor 400 of the electromechanical drivercomponent, together ensure that the upper jaw 80 and lower jaw 50 remainclamped together during the operation of the stapling mechanism. Tobegin the stapling and cutting procedure, the surgeon activates thelower motor 420 of the electromechanical driver component correspondingto the lower flexible drive shaft 430 which engages the lower drivesocket 310 at the proximal end 300 of the lower horizontal shaft 260,thereby causing the lower horizontal shaft 260 to turn in a clockwiserotation. When the stapling and cutting mechanism is in an initialloaded state, the wedge 270 and the blade 51 associated therewith are inthe channel 250 at a position closest to the proximal end 300 of thelower horizontal shaft 260. The clockwise rotation of the lowerhorizontal shaft 260 causes the outer threads 262 of the lowerhorizontal shaft 260 to engage the inner threads 292 of the horizontalthreaded bore 290 of the wedge 270, thereby causing the wedge 270 totravel through the channel 250 in a direction away from the proximal end300 of the lower horizontal shaft 260. Continuous operation of the lowermotor 420 in this manner will move the wedge 270 fully through thechannel 250. As the wedge 270 moves through the channel, the blade 51mounted to the top of the wedge cuts through the bowel, transecting it.Simultaneously, the sloped top face 280 of the wedge 270 contacts thebutts 232 of the staples 230, thereby pushing the prongs 234 of thestaples 230 through the tissue of the clamped distal end of bowel andagainst the staple guides 240, which bends and closes the staples 230.When the wedge 270 is moved fully through the channel 250, all of thestaples 230 are pushed through the tray 220 and closed, thereby staplingclosed the distal end of the bowel. Thereafter, the surgeon reverses thelower motor 420 to effect a counter-clockwise rotation of the lowerhorizontal shaft 260, which in turn moves the wedge 270 toward theproximal end 300 of the lower horizontal shaft 260. Continuous operationof the lower motor 420 in this manner eventually returns the wedge 270to its initial position.

[0044] Thereafter, the surgeon again activates the upper motor 400 toeffect a clockwise rotation of the upper horizontal shaft 150, which inturn effects a clockwise rotation of the vertical shafts 130, which inturn effects a raising of the upper jaw 80. Continuous operation of theupper motor 400 in this manner eventually places the linear clamping,cutting and stapling attachment into an open state. Thereafter, thesurgeon replaces the empty tray 220 with a full tray 220, and performsthe same clamping, cutting and stapling procedure on the proximal end ofthe bowel. Once the proximal end of the bowel is also clamped, cut andstapled, the surgeon may separate the attachment from theelectromechanical driver component, discard the attachment, and use theelectromechanical driver component for additional procedures with otherattachments.

What is claimed is:
 1. A fastening and cutting device for cutting andclosing a section of tubular tissue, comprising: a first jaw; a secondjaw disposed in parallel and opposed correspondence with the first jaw;a vertical driver means coupled to said first jaw, which driver meanscauses the first jaw to linearly travel along an axis perpendicular tothe axis of parallel correspondence of the first and second jaw, suchthat the first jaw may separate from the second jaw when the drivermeans is biased for opening of the jaws, and to close toward the secondjaw when the driver means is biased for closing of the jaws; and acutting and stapling means disposed within the second jaw and coupledwith a horizontal driver means for cutting and stapling a section oftissue disposed between the first and second jaws once the first jaw hasbeen closed onto the second jaw.
 2. The device of claim 1 , wherein thevertical driver means comprises at least one threaded turning shaft, andwherein the first jaw includes a corresponding at least one threadedbore for receiving therethrough said threaded turning shaft, wherebyrotation of the turning shaft causes the first jaw to move axially alongthe turning shaft away from, or toward the second jaw, in accordancewith the rotational direction of the turning shaft.
 3. The device ofclaim 2 , wherein the vertical driver means comprises a pair of threadedturning shafts and a horizontal gearing shaft disposed in turning angearing relationship with said pair of threaded turning shafts, therotation of the horizontal gearing shaft thereby causing the first jawto translate.
 4. The device of claim 1 , wherein the cutting andstapling means comprises a blade and wedge seated in a wedge guidechannel formed in the second jaw.
 5. A fastening and cutting attachmentfor use with an electromechanical driver device for cutting and closinga section of tubular tissue, comprising: a first jaw; a second jawdisposed in parallel and opposed correspondence with the first jaw; avertical driving mechanism means coupled to said first jaw, said drivingmechanism being actionably coupleable to the electromechanical driverdevice, which driver means causes the first jaw to linearly travel alongan axis perpendicular to the axis of parallel correspondence of thefirst and second jaw, such that the first jaw may separate from thesecond jaw when the driver means is biased for opening of the jaws, andto close toward the second jaw when the driver means is biased forclosing of the jaws.
 6. The device of claim 5 , wherein the verticaldriver means comprises at least one threaded turning shaft, and whereinthe first jaw includes a corresponding at least one threaded bore forreceiving therethrough said threaded turning shaft, whereby rotation ofthe turning shaft causes the first jaw to move axially along the turningshaft away from, or toward the second jaw, in accordance with therotational direction of the turning shaft.
 7. The device of claim 6 ,wherein the vertical driver means comprises a pair of threaded turningshafts and a horizontal gearing shaft disposed in turning an gearingrelationship with said pair of threaded turning shafts, the rotation ofthe horizontal gearing shaft thereby causing the first jaw to translate.8. The device of claim 5 , further including a cutting and staplingmeans disposed in the second jaw, said cutting and stapling means beingactionably coupled to said electromechanical driver device.